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General Neoplasia Flashcards

1
Q

Nodules of cancer frequently display central necrosis (umbilication). Causes of tumor cell death in situ include 1. apoptosis 2. ischemia 3. paucity of nutrients 4. vulnerability to host defenses

A

Causes of tumor cell death in situ include 1. apoptosis 2. inadequate blood supply & ischemia 3. a paucity of nutrients 4. vulnerability to specific and non-specifc host defenses

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2
Q

_____ is a tumor marker for

  1. adenocarcinomas of the colon
  2. malignant tumors of the pancreas, lung, and ovary
A

CEA is a tumor marker for

  1. adenocarcinomas of the colon
  2. malignant tumors of the pancreas, lung, and ovary
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3
Q

Neuroendocrine tumors can be identified by their content of _____.

A

Neuroendocrine tumors can be identified by their content of chromogranins.

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4
Q

_____ is expressed by hepatocellular and yolk sac tumors.

A

AFP is expressed by hepatocellular and yolk sac tumors.

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5
Q

Chorionic gonadotropin is secreted by ___carcinomas.

A

Chorionic gonadotropin is secreted by choriocarcinomas.

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6
Q

Tumor marker for soft tissue sarcomas. An intermediate filament.

A

Vimentin

Tumor marker for soft tissue sarcomas. An intermediate filament.

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7
Q

Malignant lymphomas are generally positive for _____.

A

Malignant lymphomas are generally positive for leukocyte common antigen (LCA).

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8
Q

Hypermethylation is an example of _____ modification.

Hypermethylation of many _____ _____ and _____ _____ genes has been demonstrated in human tumors, including the p53 pathway.

Unlike genetic changes in cancer, epigenetic changes are reversible.

A

Hypermethylation is an example of epigenetic modification.

Hypermethylation of many tumor supressor and DNA repair genes has been demonstrated in human tumors, including the p53 pathway.

Unlike genetic changes in cancer, epigenetic changes are reversible.

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9
Q

_____ are benign tumors composed of tissues from all three primary germ layers: ectoderm, mesoderm, endoderm.

They are most common in the ovary, testis, and extragonadal sites.

They contain a variety of structures – skin, neurons, glial cells, cartilage, glandular epithelium.

A

Teratomas are benign tumors composed of tissues from all three primary germ layers: ectoderm, mesoderm, endoderm.

They are most common in the ovary, testis, and extragonadal sites.

They contain a variety of structures – skin, neurons, glial cells, cartilage, glandular epithelium.

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10
Q

_____ are malignant tumors that harbor embryonal carcinoma stem cells.

A

Teratocarcinomas are malignant tumors that harbor embryonal carcinoma stem cells.

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11
Q

Localized, disordered differentiation during embryonic development results in a _____, a disorganized caricature of normal tissue components such as cartilage, blood vessels, lymphoid tissue, ducts or bronchi.

A

Localized, disordered differentiation during embryonic development results in a hamartoma, a disorganized caricature of normal tissue components such as cartilage, blood vessels, lymphoid tissue, ducts or bronchi.

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12
Q

Cancer Epidemiology - what country is associated with each cancer?

Stomach cancer: _____

Colorectal cancer: _____

Prostate cancer: _____

A

Cancer Epidemiology

Stomach cancer: Japan

Colorectal cancer: United States

Prostate cancer: American blacks

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13
Q

Disease: _____ _____

  • autosomal recessive
  • increased sensitivity to UV radiation
  • pyrimidine dimers
  • high incidence of skin cancer
  • germline mutations in gene encoding nucleotide excision repair enzyme
A

Xeroderma Pigmentosum

  • autosomal recessive
  • increased sensitivity to UV radiation
  • pyrimidine dimers
  • high incidence of skin cancer
  • germline mutations in gene encoding nucleotide excision repair enzyme
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14
Q

Li-Fraumeni syndrome

Germline mutations of _____ lead to inherited predisposition to develop cancers in many organs. The gene functions in transcriptional regulation.

A

Li-Fraumeni syndrome

Germline mutations of p53 lead to inherited predisposition to develop cancers in many organs. The gene functions in transcriptional regulation.

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15
Q

_____ _____

  • mutation in ATM gene, which codes for a nuclear phosphoprotein involved in cell cycle regulation and DNA repair
  • cerebellar degeneration
  • immunologic abnormalities
  • predisposition to cancer
A

Ataxia telangiectasia

  • mutation in ATM gene, which codes for a nuclear phosphoprotein involved in cell cycle regulation and DNA repair
  • cerebellar degeneration
  • immunologic abnormalities
  • predisposition to cancer
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16
Q

Most common causes of death from cancer in women:

  1. _____
  2. _____
A

Most common causes of death from cancer in women:

  1. Lung cancer
  2. Breast cancer
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17
Q

_____-_____ anemia is common in cancers that bleed into the GI tract, such as colorectal cancer.

A

Iron-deficiency anemia is common in cancers that bleed into the GI tract, such as colorectal cancer.

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18
Q

c-abl protooncogene on chromosome 9 t(9,22) –> _____ _____ _____

A

c-abl protooncogene on chromosome 9 t(9,22) –> chronic myelogenous leukemia

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19
Q

Neuroblastomas
small cell carcinoma of the lung
Wilms tumor
hepatoblastoma

are all associated with gene amplification of _____-family protooncogenes

A

Neuroblastomas
small cell carcinoma of the lung
Wilms tumor
hepatoblastoma

are all associated with gene amplification of myc-family protooncogenes

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20
Q

Breast cancer and Ovarian cancer are associated with gene amplification of the Erb2 or ___/___ protooncogene

A

Breast cancer and Ovarian cancer are associated with gene amplification of the Erb2 or HER2/neu protooncogene

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21
Q

C-sis protooncogene encodes _____

–associated with sarcomas and glioblastomas when it is constitutively expressed.

A

C-sis protooncogene encodes PDGF

–associated with sarcomas and glioblastomas when it is constitutively expressed.

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22
Q

_-___ encodes a receptor for HGF.

Point mutations in _-___ are involved in papillary renal cancers.

A

C-met encodes a receptor for HGF.

Point mutations in c-met are involved in papillary renal cancers.

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23
Q

Germline point mutations in _-___ are associated with

  1. multiple endocrine neoplasia (MEN) syndromes
  2. familial medullary thyroid carcinoma
A

Germline point mutations in c-ret are associated with

  1. multiple endocrine neoplasia (MEN) syndromes
  2. familial medullary thyroid carcinoma
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24
Q

Gastrointestinal tumors (GISTs)

Germline mutations in _-___ .

A

GISTs

Germline mutations in c-kit

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25
[t(5;12)] generates a fusion protein between the PDGF receptor and another motif, resulting in _____ \_\_\_\_\_.
t(5;12) generates a fusion protein between the PDGF receptor and another motif, resulting in **myelomonocytic leukemia**.
26
DNA viruses and cancer HPV - _____ cancer EBV - _____ lymphoma; _____ carcinoma
DNA viruses and cancer HPV - **cervical cancer** EBV - **Burkitt lymphoma** and **Nasopharyngeal carcinoma**
27
\_\_\_\_\_ benign smooth muscle tumors of the uterus.
**Leimyomas** are benign smooth muscle tumors of the uterus.
28
A _____ is a benign mesenchymal tumor of the left atrium.
A **myxoma** is a benign mesenchymal tumor of the left atrium.
29
\_\_\_\_\_ Tumor marker for T-cell malignancies.
**CD4** Tumor marker for T-cell malignancies.
30
HMB-45, S-100 protein Tumor markers for _____ \_\_\_\_\_.
HMB-45, S-100 protein Tumor markers for **malignant melanoma**.
31
\_\_\_\_\_ Tumor marker for muscle tumors.
**Desmin** Tumor marker for muscle tumors.
32
\_\_\_\_\_ Tumor marker for medullary carcinoma of the thyroid.
**Calcitonin** Tumor marker for medullary carcinoma of the thyroid.
33
Routes of _____ \_\_\_\_\_. 1. Hematogenous 2. Lymphatic 3. Seeding of body cavities
Routes of **tumor metastasis** 1. Hematogenous 2. Lymphatic 3. Seeding of body cavities
34
A malignant tumor of epithelial origin is a \_\_\_\_\_ A malignant tumor of mesenchymal origin is a \_\_\_\_\_
A malignant tumor of epithelial origin is a **carcinoma** A malignant tumor of mesenchymal origin is a **sarcoma**
35
Secondary descriptors of tumor morphologic appearance \_\_\_\_\_ : frondlike structure \_\_\_\_\_ : dense fibrous stroma \_\_\_\_\_ intraductal neoplasm in which necrotic material can be expressed from ducts
Secondary descriptors of tumor morphologic appearance **papillary** : frondlike structure **scirrhous or desmoplastic** : dense fibrous stroma **comedocarcinoma**: intraductal neoplasm in which necrotic material can be expressed from ducts
36
The definition of a benign tumor resides in its **inability** to _____ adjacent tissues and to \_\_\_\_\_. The lining epithelium of a benign tumor resembles that of the normal tissue.
The definition of a benign tumor resides in its inability to **invade** adjacent tissues and to **metastasize**. The lining epithelium of a benign tumor resembles that of the normal tissue.
37
Histologic Features of Malignancies \_\_\_\_\_ - lack of differentiated features abundant mitotic activity disorganized and random growth pattern invasion of blood vessels and lymphatics metastases
Histologic Features of Malignancies **anaplasia** - lack of differentiated features abundant mitotic activity disorganized and random growth pattern invasion of blood vessels and lymphatics metastases
38
Tumor markers for cancers nuclear receptors for estrogen, progesterone : \_\_\_\_\_ Lewis a antigen (CA 19-9): _____ and \_\_\_\_\_ CA 125: \_\_\_\_\_
Tumor markers for cancers nuclear receptors for estrogen, progesterone : **breast** Lewis a antigen (CA 19-9): **pancreatic** and **gastrointestinal** CA 125: **ovarian**
39
carcinoma that does not penetrate the basement membrane
**Carcinoma in situ** carcinoma that does not penetrate the basement membrane
40
Invasion and Metastasis are Multi-Step Events 1. Invasion of the *basement membrane* 2. Movement thru *extracellular matrix* 3. Penetration of *vascular or lymphatic drainage* 4. Survival and arrest within *circulating blood or lymph* --passage through ECM, invade thru BM-- 5. Survival and growth as a metastasis (requires angionesis)
41
Adhesion Molecules \_\_\_\_\_\_\_\_\_\_ transmembrane receptors that mediate cell-matrix and cell-cell attachment, and stimulate intracellular signaling and gene expression
Adhesion Molecules **Integrins** transmembrane receptors that mediate cell-matrix and cell-cell attachment, and stimulate intracellular signaling and gene expression
42
Adhesion Molecules \_\_\_\_\_ and \_\_\_\_\_ - suppress invasion and metastasis - decreased expression in most carcinomas, leading to mestases
Adhesion Molecules **E-cadherin** and **Catenins** - suppress invasion and metastasis - decreased expression in most carcinomas, leading to mestases
43
Malignant cells make proteolytic enzymes that help degrade the basement membrane. Examples 1. 2.
Malignant cells make proteolytic enzymes that help degrade the basement membrane. Examples 1. **u-Pa** (urokinase-type plasminogen activator, which converts plasminogen to the protease, plasmin) 2. **MMPs**
44
FGF, VEGF, TGF-beta, and PDGF all stimulate \_\_\_\_\_ \_\_\_\_\_
FGF, VEGF, TGF-beta, and PDGF all stimulate **tumor angiogenesis**
45
The fate of foci of cancer micrometastases
The fate of foci of cancer micromestases
46
Cancer _____ reflects cellular characteristics, like organization and cytology. Cancer _____ refers to the extent of spread.
Cancer **grading** reflects cellular characteristics, like organization and cytology. Cancer **staging** refers to the extent of spread. T : size of primary tumor N : regional node metastases M : presence and extent of distant metastases
47
Monoclonal Origin of Cancer: cancers arise from a single transformed cell
Monoclonal Origin of Cancer
48
Tumor Heterogeneity and Clonal Evolution
Tumor Heterogeneity and Clonal Evolution
49
Tumor Heterogeneity and Cancer Stem Cells
Tumor Heterogeneity and Cancer Stem Cells An oncogenic stimulus to a stem or progenitor cell may lead to an expanded pool of transformed stem/progenitor cells. If a transformed cell **reacquires a program of self-renewal**, the resulting transformed cell may become a **cancer stem cell**.
50
Tumor Heterogeneity and Epigenetic Cancer Cell Plasticity
Tumor Heterogeneity and Epigenetic Cancer Cell Plasticity Epigenetic changes in cell populations may lead to tumor progression or cell death.
51
Regulation of the Cell Cycle
Regulation of the Cell Cycle
52
Some rare malignant clones have ______ \_\_\_\_\_\_*,* thereby avoiding senescence and leading to cell immortalization.
Some rare malignant clones have **activated telomerase**, thereby avoiding senescence and leading to cell immortalization.
53
Gene: MSH Function? Syndrome? Predominant malignancies? Carcinomas: _____ / _____ / _____ / \_\_\_\_\_ Other cancer: _____ \_\_\_\_\_
Gene: MSH Function: **DNA repair** Syndrome: **HNPCC/Lynch Syndrome** Predominant malignancies: **carcinomas [colon, endometrium, ovary, and bladder] malignant melanoma**
54
3 Mechanisms of Genetic Instability in Neoplasms 1. _____ instability 2. _____ instability 3. aberrant ___ \_\_\_\_\_
3 Mechanisms of Genetic Instability in Neoplasms 1. **chromosomal** instability 2. **microsatellite** instability (secondary to abnormal DNA mismatch repair) 3. aberrant **DNA methylation**
55
NORMAL human genes involved in cellular growth regulation, proliferation, gene expression \_\_\_\_\_\_\_ MUTANT versions of these genes \_\_\_\_\_\_\_
NORMAL human genes involved in cellular growth regulation, proliferation, gene expression **Proto-Oncogenes** MUTANT versions of these genes **Oncogenes**
56
\_\_\_\_\_ \_\_\_\_\_ c-myc is a protooncogene on chromosome \_\_\_ t(8,14) results in c-myc activation and constitutive expression *(overproduction of normal gene product)* This leads to emergence of a dominant clone of B cells, driven relentlessly to proliferate
**Burkitt's Lymphoma** c-myc is a protooncogene on chromosome **8** t(8,14) results in c-myc activation and constitutive expression (overproduction of normal gene product) This leads to emergence of a dominant clone of B cells, driven relentlessly to proliferate
57
The activation of the ___ proto-oncogene is the most frequent dominant mutation in human cancers.
The activation of the **ras** proto-oncogene is the most frequent dominant mutation in human cancers.
58
The two-hit origin of retinoblastoma: The tumor suppressor Rb gene on chromosome 13. The function of Rb genes is a critical checkpoint in the cell cycle, and ______ mutations in Rb permit unregulated cell proliferation.
The two-hit origin of retinoblastoma: The tumor suppressor Rb gene The function of Rb genes is a critical checkpoint in the cell cycle, and **inactivating** mutations in Rb permit unregulated cell proliferation. \*Loss of Heterozygosity\*
59
Susceptibility to retinoblastoma is inherited in a _______ fashion because it is the heterozygote that develops the disease. But the genetic defect in the tumor itself is \_\_\_\_\_\_\_.
Susceptibility to retinoblastoma is inherited in a **dominant** fashion because it is the heterozygote that develops the disease. But the genetic defect in the tumor itself is **recessive**.
60
The p53 tumor suppressor gene is the principal mediator of growth arrest, senescence, and apoptosis. Most human cancers display either 1) inactivating mutations of p53 2) abnormalities in the proteins that regulate p53 activity, such as _____ and \_\_\_\_\_.
The p53 tumor suppressor gene is the principal mediator of growth arrest, senescence, and apoptosis. Most human cancers display either 1) inactivating mutations of p53 2) abnormalities in the proteins that regulate p53 activity, such as **MDM2** and **ARF (p14)**
61
Syndrome: familial adenomatous polyposis Gene: \_\_\_ Protooncogene or Tumor Suppressor? Predominant cancer: \_\_\_\_\_\_\_\_
Syndrome: familial adenomatous polyposis **APC** **Tumor Suppressor Gene** **Colorectal carcinoma**
62
Gene: WT1 Predominant malignancies: _____ ; \_\_\_\_\_\_
Gene: WT1 Predominant malignancies: Wilms tumor, AML
63
Gene: BRCA1, BRCA2 Oncogene or Tumor Suppressor? Predominant cancers: \_\_\_\_\_, \_\_\_\_\_
Gene: BRCA1, BRCA2 Tumor Suppressor Predominant cancers: breast, ovarian
64
Syndrome: Cowden syndrome Gene: \_\_\_\_\_ Oncogene or Tumor Suppressor? Predominant malignancies: \_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_
Syndrome: Cowden syndrome Gene: **PTEN** **Tumor Suppressor** Predominant malignancies: **colorectal, breast, thyroid** \*PTEN is an important suppressor of sporadic (non-hereditary) tumor development.
65
Syndrome: Neurofibromatosis type 1 Gene: \_\_\_ Oncogene or Tumor Suppressor? Predominant malignancies: _______ sarcomas
Syndrome: Neurofibromatosis type 1 Gene: **NF-1** **Tumor Suppressor** Predominant malignancies: **neurogenic** sarcomas
66
Syndrome: Von Hippel-Lindau Gene: \_\_\_ Oncogene or Tumor Suppressor? Predominant malignancy: \_\_\_\_\_\_\_
Syndrome: Von Hippel-Lindau Gene: **VHL** **Tumor Suppressor** Predominant malignancy: **renal cell carcinoma**
67
Most cancers display global \_\_\_\_\_methylation compared to normal tissue.
Most cancers display global *hypo*methylation compared to normal tissue.
68
\_\_\_\_\_-\_\_\_\_\_ \_\_\_\_\_\_\_ Process by which malignant epithelial cells adopt a disguise as single, nonpolarized, mobile mesenchymal cells. This process is facilitated by loss of E-cadherin.
**Epithelial-Mesenchymal Transition** Process by which malignant epithelial cells adopt a disguise as single, nonpolarized, mobile mesenchymal cells. This process is facilitated by loss of E-cadherin.
69
Viruses and Cancer HBV and HCV - _____ carcinoma HHV 8 - _____ \_\_\_\_\_
DNA Viruses and Cancer HBV and HCV - **Hepatocellular carcinoma** HBV = hepatitis B virus (*DNA virus*) HCV = hepatitis C virus (*RNA virus*) HHV8 - **Kaposi sarcoma** HHV8 is also implicated in "primary effusion lymphoma" and "multicentric Castleman disease" HHV8 = human herpes virus 8
70
RNA retrovirus and Cancer HTLV-I : ____ leukemia/lymphoma
RNA retrovirus and Cancer HTLV-I : **T-cell leukemia/lymphoma** HTLV-I = human T-cell leukemia virus type 1
71
Oncogenic DNA viruses have genes that encode protein products that *bind to and inactivate* the products of _____ \_\_\_\_\_ \_\_\_\_\_.
Oncogenic DNA viruses have genes that encode protein products that *bind to and inactivate* the products of **tumor suppressor genes.**
72
The most common neoplasm associated with AIDS is _____ \_\_\_\_\_. The virus associated with this cancer is \_\_\_\_\_.
The most common neoplasm associated with AIDS is **Kaposi sarcoma.** The virus associated with this cancer is **HHV 8**.
73
Chemical Carcinogens PVC factory workers : _____ \_\_\_\_\_
Chemical Carcinogens PVC factory workers : **hepatic angiosarcoma**
74
Chemical Carcinogens Alkylating agents used in chemotherapy carry a significant risk of \_\_\_\_\_.
Chemical Carcinogens Alkylating agents used in chemotherapy carry a significant risk of **leukemias.**
75
Chemical Carcinogens Aflatoxin B1 is a potent _____ carcinogen, and is especially common in parts of Africa and Asia. Aflatoxin B1 is formed in vegetable foods exposed to warm, moist conditions.
Chemical Carcinogens Aflatoxin B1 is a potent **liver** carcinogen, and is especially common in parts of Africa and Asia. Aflatoxin B1 is formed in vegetable foods exposed to warm, moist conditions.
76
Chemical Carcinogens Occupational exposure to aniline dyes can result in _____ cancer.
Chemical Carcinogens Occupational exposure to aniline dyes can result in **bladder** cancer.
77
Chemical Carcinogens Nitrosamines may play a role in _____ neoplasms.
Chemical Carcinogens Nitrosamines may play a role in **gastrointestinal** neoplasms. ex: high incidence of esophageal cancer in Hunan province of China due to high dietary content
78
Chemical Carcinogens Nickel/Cadmium metals are associated with _____ cancer in factory workers.
Chemical Carcinogens Nickel/Cadmium metals are associated with **lung** cancer in factory workers.
79
Physical Carcinogens Asbestos causes \_\_\_\_\_. Asbestos is widely used in construction, insulation, and manufacturing.
Physical Carcinogens Asbestos causes **mesothelioma.**
80
Tumor-\_\_\_\_\_ antigens represent somatic mutations or alterations in protein processing, unique to tumor and patient.
**Tumor-specific antigens** represent somatic mutations or alterations in protein processing, unique to tumor and patient.
81
Tumor-\_\_\_\_\_ antigens reflect the production of normal proteins, either in excess or in a setting different from their normal expression. These antigens are recognized as "self" by the immune system, and thus do not lead to effective immune responses. ex: oncospermatogonial antigens differentiation antigens oncofetal antigens overexpressed antigens
**Tumor-associated antigens** reflect the production of normal proteins, either in excess or in a setting different from their normal expression. These antigens are recognized as "self" by the immune system, and thus do not lead to effective immune responses. ex: oncospermatogonial antigens differentiation antigens oncofetal antigens overexpressed antigens
82
Cancer is often accompanied by an _____ metabolic rate, which may explain the paraneoplastic syndrome of *anorexia, weight loss, and cachexia.*
Cancer is often accompanied by an **evelavted** **metabolic rate**, which may explain the paraneoplastic syndrome of *anorexia, weight loss, and cachexia.*
83
Paraneoplastic Syndromes Cushing Syndrome results from ectopic secretion of _____ by a tumor. - hypokalemia - hyperglycemia - hypertension - muscle weakness
Paraneoplastic Syndromes Cushing Syndrome results from ectopic secretion of **ACTH** by a tumor. - hypokalemia - hyperglycemia - hypertension - muscle weakness
84
Paraneoplastic Syndromes Inappropriate antidiuresis is associated with production of \_\_\_\_\_. The tumor that most often produces this syndrome is \_\_\_\_\_\_\_\_\_.
Paraneoplastic Syndromes Inappropriate antidiuresis is associated with production of **ADH**. The tumor that most often produces this syndrome is **small cell lung carcinoma**.
85
Paraneoplastic Syndromes The most common cause of hypercalcemia is the secretion of a PTH-like peptide by an _____ tumor, such as small cell lung carcinoma or breast adenocarcinoma.
Paraneoplastic Syndromes The most common cause of hypercalcemia is the secretion of a PTH-like peptide by an **epithelial** tumor, such as small cell lung carcinoma or breast adenocarcinoma.
86
Paraneoplastic Syndromes Venous thrombosis is usually associated with _____ carcinoma.
Paraneoplastic Syndromes Venous thrombosis is usually associated with **pancreatic** carcinoma.
87
Acanthosis nigricans is frequently associated with _____ carcinomas.
Acanthosis nigricans is frequently associated with **gastrointestinal** carcinomas, especially stomach cancers.

CK Heme Onc (13 decks)

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